| Date | Time | ||
|---|---|---|---|
| Supplier | Shipment No. | ||
| Received By | Reference |
| Item | Pass | Fail | Comments |
|---|---|---|---|
| Packaging intact & without damage | |||
| Correct labeling/barcodes | |||
| No signs of contamination or pest | |||
| Quantity as per delivery note | |||
| Product within expiry/best before date | |||
| Other (specify) |
| Name | Signature | Date |
|---|